Monotherapy using Cefepime in Comparison to Dual Therapy (PIP/TAZO plus Amikacin) for Febrile Neutropenic Pediatric Patients with Solid Tumors

摘要: Infectious diseases are important causes of morbidity and mortality in patients with cancer. Neutropenia has been recognized form any decades as a major risk factor for the development infections cancer undergoing chemotherapy. Effective strategies to anticipate, prevent, manage infectious complications neutropenic have led improved outcomes. The aim this study was compare efficacy safety Cefepime monotherapy versus dual therapy PIP/TAZO plus Amikacin empirical treatment fever children solid tumors. Data one hundred thirty episodes 80 treated well twenty 62 were analyzed. These occurred tumors who admitted pediatric oncology department at National Cancer Institute, Cairo University between February 2012 2013. Patients arm received 50 mg/kg/dose every 8 hours. Whereas, those 100mg/kg/dose hours 15 mg/kg/day. Modification defined addition or shifting other antimicrobials. Success without modifications 87.6% & 86.7% arms; respectively. incidence MDROs lower among compared (p=0.013). Nephrotoxicity higher (p=0.004). Glycopeptides added slightly more arm. rate gram positive bacteremia than that negative both arms. There no significant difference 2 arms regarding median duration neutropenia, hospitalization crude rate. Monotherapy effective safe initial febrile Combination regimens contain aminoglycosides did not improve success, but it may increase nephrotoxicity, resistance, cost.